Male breast disease

Male breast disease includes a wide spectrum of conditions. Many conditions and entities that affect the female breast may also affect the male breast. 

The most common breast changes seen in the breast are senescent. As the person ages there is progressive fatty deposition in the breast as well as pectoral muscle volume loss. This has been called pseudogynecomastia. In gynecomastia there is a palpable mass; senescent breast changes in the male do not include a palpable mass.

These are invariably infiltrating ductal carcinomas (IDC). The imaging characteristics and clinical manifestations are indistinguishable from the disease in the non male  breast. There is no way of distinguishing the gender of the patient by looking at imaging. This is a scarce disease even in busy breast centres.

The diagnosis is sometimes delayed due to the patient's hesitancy to seek advice. Workup from a radiological point of view is the same as for women including the use of needle biopsy to confirm the diagnosis.

Invariably in gynecomastia there is glandular opacification abutting the posterior aspect of the areola. IDC can occur anywhere in the breast. You will not find gynecomastia and should not consider it as a diagnosis if the area of opacification is remote from the posterior aspect of the areola. Skin thickening and tethering are  not part of gynecomastia. The ultrasound images of gynecomastia are pathognomonic; there is a hyopechoic, usually well defined  triangle of breast tissue behind the nipple. The apex of the triangle abuts the posterior aspect of the areola.

In the minority of cases gynecomastia is bilateral. In bilateral cases ultrasound imaging may suffice without mammography.

The genetic predisposition for carcinoma breast can be inherited from both mother and father. First line family history includes both genders.

Due to the absence of lobules in the breast breast, the following conditions are extremely uncommon

Breast imaging and pathology
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Article information

rID: 14533
Systems: Breast, Oncology
Section: Gamuts
Synonyms or Alternate Spellings:
  • Male breast conditions
  • Conditions affecting the male breast

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Cases and figures

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    Case 1: gynecomastia
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    Case 2: breast cancer
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    Case 3
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